Chronic refractory tibia osteomyelitis treated with adjuvent hyperbaric oxygen: a preliminary report.

BACKGROUND: Refractory osteomyelitis is a serious disease that fails to respond to aggressive medical and surgical treatment. A plethora of alternative therapies have evolved. Hyperbaric oxygen has been proven to enhance bone and soft tissue healing in many in vitro and in vivo studies. This article presents the preliminary results of adjunctive hyperbaric oxygen therapy in patients with refractory osteomyelitis. MATERIALS AND METHODS: Fifteen patients who were diagnosed with refractory tibia osteomyelitis were treated prospectively with adjunctive hyperbaric oxygen therapy, aggressive surgical debridement, and parenteral antibiotic treatment. The effectiveness was evaluated with an average follow-up of 17.2 months. RESULTS: The hyperbaric oxygen therapy averaged 26 daily sessions. Successful treatment was achieved in 13 patients (86%). The mean length of treatment was 45 days. The preliminary results are comparable with other series. CONCLUSION: Hyperbaric oxygen is effective as an adjunct to aggressive medical and surgical management in refractory osteomyelitis. A precise clinical staging system for patient selection and treatment organization is imperative to successful outcome.